David Badalov

Primary specialty

DentistTaxonomy code 122300000X

License

060608 Issued in NY

Practice address

13511 78TH Dr
Flushing, NY 11367-3235

Phone

(646) 441-7711

NPI assigned

Mar 23, 2018

Last updated

Dec 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1316441298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13511 78TH DR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13511 78TH DR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673235",
            "telephone_number": "646-441-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADALOV",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060608",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baburao Doddapaneni MD PC
• Nina Ricci Bacayo, RPT
• Janet Miran Back, DO
• Melodie Back, LMHC
• Bada Physical Therapy PC
• Ilya Badalov, MD
• Izobela Badalova, OTR/L
• Roza Badalova
• Zinaida Badalova
• Chardonnay L Badchkam, LMHC

• Dentist in Flushing, NY
• Providers in Flushing, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.